Individual provider Active NPI

Kristen Lynn Pruitt, MA, NCC

  • Mental Health Counselor
  • Orlando, FL
National Provider Identifier
1366606253
Registry record updated Jul 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
5766 S Semoran Blvd
Orlando, FL 32822-4818
Phone
(407) 896-2323
Fax
(407) 896-7760
NPI assigned
Jul 10, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

5766 S Semoran Blvd
Orlando, FL 32822-4818

Mailing address

5766 S Semoran Blvd
Orlando, FL 32822-4818
Phone (407) 896-2323

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260417001364 MD Practitioner - Mental Health Counselor 0648746511 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2010
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

849 Fairmont Ave
Towson, MD 21286

849 Fairmont Ave
FL. 5
Towson, MD 21286-2624

849 Fairmount Ave
FL 5
Towson, MD 21286-2699

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1215648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215648000000",
    "number": "1366606253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5766 S SEMORAN BLVD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328224818",
            "telephone_number": "407-896-2323",
            "fax_number": "407-896-7760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5766 S SEMORAN BLVD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328224818",
            "telephone_number": "407-896-2323",
            "fax_number": "407-896-7760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRUITT",
        "first_name": "KRISTEN",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "MA, NCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-10",
        "last_updated": "2008-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.